Better Breathing with COPD

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1 Better Breathing with COPD People with Chronic Obstructive Pulmonary Disease (COPD) often benefit from learning different breathing techniques. Pursed Lip Breathing Pursed Lip Breathing (PLB) can be very helpful to people with COPD because it removes trapped air in the lungs and increases ventilation. PLB is useful during any difficult or heavy activity. PLB Technique 1. Relax neck and shoulder muscles. 2. Breathe in slowly through your nose (count to 2), keeping your mouth closed. 3. Pucker or purse your lips as you slowly breathe out (count to 4). 4. Practice this exercise 4 to 5 times a day. Diaphragmatic Breathing Diaphragmatic breathing is an exercise to strengthen your diaphragm, a huge muscle that helps you breathe. The diaphragm helps push the air out of your lungs but with COPD the muscle becomes flattened and does not work as well. Practicing diaphragmatic breathing helps to strengthen the muscle making it easier to breathe and push the stale air from your lungs. Diaphragmatic Breathing Technique 1. When you first start to practice this technique it is recommended that you lie down. 2. Put a pillow behind your head and under your knees. 3. Put one hand below your rib cage over the center of your stomach. 4. Put one hand over your upper chest. 5. While breathing in through your nose push out your stomach muscles, your upper chest should not move. 6. While slowly breathing out, through pursed lips, pull in your stomach muscles. 7. You may need to force your stomach muscles to move like this until you have learned the process. 8. You need to use your diaphragm to breathe, not your chest muscles 9. Always try to use your diaphragm to breathe. FS 72.9 Data Classification: Public Domain VAM.CT.COPDBetterBreathing (3/12)

2 Living Day to Day with Chronic Obstructive Pulmonary Disease (COPD) Medicines Take all of your medicines as directed by your doctor. If you have any questions about the proper way to take your medicine, ask your doctor or pharmacist. Take a list of all medicines to your doctor appointments, including strength and frequency. Stop smoking Stop smoking. It is the best thing you can do for your lungs. Ask your doctor for tips on quitting and if patches, gum or other medications would be helpful. Keep your air clean Avoid smoke and strong odors in your home. Cook in a ventilated area. Use your stove hood if available. Limit outside exposure on heavily polluted days. Keep your windows and doors closed to avoid pollution in your house. Going Out Go out during the time of the day that you have the most energy. Avoid going to stores during busy times of day. Limit stores with stairs. Going on vacation? Ask your doctor what to bring should you have problems. Keep strong Check with your doctor before starting an exercise program. Walking is a good exercise. It increases strength in your arms and legs, making it easier to move. Breathing exercises can help if you are having trouble breathing. Exercising strengthens the muscles you need to breath. Eat 5 to 6 small meals a day. Eat lots of fruits and vegetables. Eat lean protein, such as fish, chicken, turkey, and soy. If you get short of breath while eating, eat slower. If you are overweight, ask your doctor about weight loss. If you are underweight, ask your doctor about a diet to gain weight. Plan for rest periods throughout the day to conserve energy. Doctor appointments Ask your doctor about vaccines. It is important to get a pneumonia vaccine and an annual flu shot. See your doctor at least twice a year for checkups. FS 77.0 Data Classification: Public Domain VAM.CT.COPD Day to Day (3/12)

3 Chronic Obstructive Pulmonary Disease (COPD) Inhalers and Spacers COPD Inhalers COPD inhalers contain the medication for your COPD. There are many types of inhalers, so you will need to talk with your doctor about the inhaler that is right for you. In general, people with COPD should use a spacer with their inhaler, as directed below. If you do not have your spacer with you or if your doctor directs you not to use one, please use the directions below to use your inhaler. Aerochamber (Spacer) It is important for your doctor to show you how to use your inhaler with your spacer or aerochamber. Without this device, the medication will go down the back of your throat and stay there. A spacer helps the medication travel down your airways to your lungs. The spacer attaches to the mouth piece of your inhaler. The medication is held in the chamber until you slowly inhale the medicine in three deep breaths (or as directed by your doctor). You should wait one minute between inhalations. A spacer will also help prevent thrush (a yeast infection in your mouth) when using an inhaled corticosteroid medication. You should always rinse your mouth after using your inhaler and spacer. Using Your Inhaler With a Spacer Attach the inhaler to the spacer. Shake very well. Put the mouth piece of the spacer in your mouth. Push down on the canister. Take a slow deep breath in and hold your breath for a few seconds. Repeat the previous step, as directed by your doctor. Using Your Inhaler Without a Spacer Stand upright, remove the cap and hold the canister in your hand. Shake well. Take a deep breath in and let it out. Put mouthpiece one to two inches from your mouth, push down on the canister and breathe in slowly (hold your breath with each dose, about 10 seconds). Wait seconds and repeat the above steps as directed by your doctor. FS 74.5 Data Classification: Public Domain VAM.CT.COPDInhaler (3/12)

4 Living With Chronic Obstructive Pulmonary Disease (COPD) What is Chronic Obstructive Pulmonary Disease? Chronic Obstructive Pulmonary Disease (also called COPD) is a chronic disease of the lungs. Obstruction in COPD means that the flow of air in and out of the lungs is less than it should be. When that happens less oxygen gets into the body tissues and it becomes harder to get rid of carbon dioxide which is the waste gas. There are two main illnesses with COPD, chronic bronchitis and emphysema. Chronic bronchitis causes mucus to build up in your airways making it hard to breathe. With emphysema the walls of the air sacs in the lung are broken down and the air spaces get larger and air gets trapped. What causes COPD? Smoking is the main cause for COPD. Other reasons include air pollution, second-hand smoke, heredity and history of childhood respiratory infections. The best way to prevent or stop COPD from getting worse is to quit smoking. How do you treat COPD? If you smoke the best thing you can do is to stop smoking. Quitting can stop or slow the damage to your lungs. Ask your doctor for tips on quitting. Your doctor may start you on some medicines to help you breathe better. They can include antibiotics and inhalers. You may also need to take steroids and antibiotics if you get a respiratory infection. If you have severe COPD you may need to use oxygen. Are there complications for COPD? You may be more likely to get colds or respiratory infections. Wash your hands often and avoid crowds during cold and flu season. It is very important to get a flu shot every year. You should also get a pneumonia vaccine. What can I do to breathe better? Do not smoke. Avoid second hand smoke. Take your medicine as ordered. Avoid strong odors, dust and fumes. Avoid temperature extremes and humidity. Stay active according to your tolerance. Eat 5 to 6 small meals a day. See your doctor on a regular basis. If you have severe COPD, make each breath count: Do things slowly. Do things sitting down. Ask your family and friends to help. Wear loose fitting clothing. Ask for help moving items around your house; use a rolling cart to move heavy items. Reference: American Lung Association FS 74.4 Data Classification: Public Domain VAM.CT.COPD (3/12)

5 How To Manage Your COPD If you have any of these: No shortness of breath No coughing, wheezing or chest tightness Clear thinking A small amount of sputum Normal breathing when you do your regular activities Then do all of these: Continue your normal activities. Take your medications as prescribed. Keep all of your doctor appointments. Breathing problems at night that interfere with sleep Shortness of breath that interferes with daily activities An increase in wheezing or coughing A need to use your nebulizer or inhaler more than twice per week An unexplained increase or decrease in weight along with swelling in your feet and ankles Thick, sticky sputum that is green or yellow Forgetfulness, restlessness, fatigue or trouble sleeping Use pursed lip or diaphragmatic breathing and relaxation exercises. Pace yourself and limit your activities. Use nebulizer or your rescue inhaler as ordered by your doctor. Increase your medications ONLY if directed by your doctor. Call your doctor if no better within 1-2 hours and inform him or her about sputum changes. Trouble breathing or have chest pain Increased difficulty breathing at rest or need to sleep on more pillows or in a chair Trouble coughing up any sputum or you have blood in your sputum Confusion, slurred speech or feel like you are going to faint Trouble doing any activities Drowsiness or it is very difficult to wake up Wheezing or shortness of breath not relieved by your inhaler or nebulizer Call your doctor NOW. Call 911 if you are unable to talk to your doctor. FS 58.7 Data Classification: Public Domain VAM.CT.COPDManage (3/12)

6 COPD Medications Chances are you are taking medications for your COPD on a regular basis. These medicines help control your symptoms so you can breathe better, everyday. Bronchodilators These are medicines taken via inhalers or nebulizers. They relax the muscles around your airways. They help relieve coughing and shortness of breath. This can help your breathing. You may need more than one of these drugs, depending on the severity of your COPD. You might take a short-acting one before activities. Also, you may use a long-acting one every day. Inhaled Corticosteroids Inhaled steroids help reduce airway swelling. This helps you breathe better. But they have some side effects. These drugs are usually for people with moderate or severe COPD. Antibiotics Respiratory infections (like acute bronchitis, pneumonia and influenza) can make your COPD symptoms worse. Antibiotics are only recommended when necessary. Remember! Take your medicines as prescribed by your doctor. Talk to your doctor if you have any questions. FS 61.3 Data Classificataion: Public Domain VAM.CT.COPDMeds (3/12)

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